Maple Leaf Taxi

Government Accounts

* Required Information

First Name *	Question Mark First Name of the Authorized Officer
Last Name *	Question Mark Last Name of the Authorized Officer
Ministry Name *
Department Name *
Level of Goverment	Federal Provincial Municipal
Street Address *	Question Mark Please enter complete address of the company including any suite numbers.
Postal / Zip Code *
Phone Number *	Question Mark Please specify Extension number e.g 416-000-0000 Ext 123
Email Address *	Question Mark Email address of the authorized officer
Signature *	Question Mark Authorized officers Initial
Account Details	Question Mark Please mention any important information you think is necessary for Imperial Taxi to know about your requirements.
Agree to Terms and Conditions *	Question Mark Please read the terms and conditions below. Your processing of this application means that you agree with the terms mentioned below.